Repair of Large Ventricular Septal Defects in Infants and Small Children
| Autor: | James V. Richardson, Pamela Stewart, Ronald M. Lauer, Richard M. Schieken, Donald B. Doty |
|---|---|
| Rok vydání: | 1982 |
| Předmět: |
Heart Septal Defects
Ventricular Male medicine.medical_specialty Hemodynamics Increased pulmonary vascular resistance Pulmonary Artery Pulmonary artery banding Internal medicine medicine Humans cardiovascular diseases New York Heart Association Class I Vascular disease business.industry Age Factors Infant Newborn Small children Infant medicine.disease Surgery medicine.anatomical_structure Vascular resistance Cardiology Right atrium Female Vascular Resistance business Research Article Follow-Up Studies |
| Zdroj: | Annals of Surgery. 195:318-322 |
| ISSN: | 0003-4932 |
| DOI: | 10.1097/00000658-198203000-00012 |
| Popis: | It is possible to achieve excellent results for primary closure of ventricular septal defects regardless of the age of the patients when surgical intervention is required. Thirty-two severely symptomatic patients, age 1-24 months, with large ventricular septal defects (m Qp/Qs = 3.4, m R VSD = 4.0), had primary repair of the defects with one (3%) hospital death. Seven patients (22%) had increased pulmonary vascular resistance ranging from 5.4 to 12 units/m2. It was possible to close the ventricular septal defect through the right atrium in 26 patients (81%). Pulmonary artery banding was not performed in any patient with isolated ventricular septal defect during the period of this study. The 31 survivors have been followed an average of four years, and 30 of them are remarkably improved and remain New York Heart Association Class I or II. Only one patient, with obstructive pulmonary vascular disease (pulmonary resistance = 12 U/m2), died suddenly 16 months after operation. Follow-up catheterization was offered to all patients, and to date, 18 (60%) have been restudied. These hemodynamic data show that pulmonary vascular resistance after surgery is usually normal or only minimally elevated; except for one patient with a large residual ventricular septal defect, functionally significant left to right shunts were eliminated. These results and the analysis of results of combined series reported in the literature for primary and staged operations for the continued practice of primary repair of isolated large ventricular septal defects in infants and children who require surgery. |
| Databáze: | OpenAIRE |
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